特利加压素对脓毒性休克血流动力学及组织氧合的作用  

Effects of terlipressin on hemodynamics and tissue oxygenation in septic shock

作　　者：高华新 GAO Huaxin(Department of Emergency Critical Medicine,Yijishan Hospital,Wannan Medical College,Wuhu Anhui 241001,China)

机构地区：[1]皖南医学院弋矶山医院急诊重症医学科,安徽芜湖241001

出　　处：《蚌埠医学院学报》2024年第5期629-632,共4页Journal of Bengbu Medical College

摘　　要：目的:分析特利加压素(TP)对脓毒性休克血流动力学及组织氧合的作用。方法:选择70例脓毒性休克病人作为研究对象,按随机数字表法分为对照组和观察组,各35例。对照组给予去甲肾上腺素(NE)治疗,观察组在对照组的基础上给予TP治疗。比较2组NE用量、血流动力学指标、氧代谢指标、并发症、28 d内生存率。结果:对照组NE用量高于观察组(P<0.05)。2组治疗前心率(HR)、平均动脉压(MAP)差异均无统计学意义(P>0.05);2组治疗6、12、24 h的HR均低于本组治疗前(P<0.05),MAP均高于本组治疗前(P<0.05);对照组治疗6、12、24 h的HR均明显高于观察组(P<0.01),对照组治疗12、24 h的MAP均低于观察组(P<0.01和P<0.05)。2组治疗前血氧饱和度(SaO_(2))、氧合指数(PaO_(2)/FiO_(2))、血乳酸(Lac)差异均无统计学意义(P>0.05);2组治疗6、12、24 h的SaO_(2)、PaO_(2)/FiO_(2)均高于本组治疗前(P<0.05),Lac均低于本组治疗前(P<0.05);对照组治疗6、12、24 h的SaO_(2)、PaO_(2)/FiO_(2)均低于观察组(P<0.05~P<0.01),Lac均高于观察组(P<0.05~P<0.01)。对照组并发症发生率为17.14%(6/35),与观察组的25.71%(9/35)差异无统计学意义(P>0.05)。对照组28 d内生存率为68.57%(24/35),与观察组的62.86%(22/35)差异无统计学意义(P>0.05)。结论:TP可明显减少NE用量,更快达到复苏目标,从而改善脓毒性休克病人的血流动力学及组织氧合情况。Objective:To analyze the effect of terlipressin(TP)on hemodynamics and tissue oxygenation in septic shock.Methods:Seventy patients with septic shock were selected as the study subjects,and divided into control group and observation group according to the random number table method,with 35 cases in each group.The control group was given norepinephrine(NE)treatment,and the observation group was given TP treatment on the basis of the control group.The dosage of NE,hemodynamic indexes,oxygen metabolism indexes,complications,and survival rate within 28 days were compared between the two groups.Results:The dosage of NE in the control group was higher than that of observation group(P<0.05).There was no significant difference in heart rate(HR)and mean arterial pressure(MAP)between the two groups before treatment(P>0.05);HR at 6,12 and 24 h after treatment in the two groups were lower than that before treatment(P<0.05),and MAP was higher than that in its group before treatment(P<0.05);HR at 6,12 and 24 h after treatment in the control group was significantly higher than that in the observation group(P<0.01),and MAP at 12 and 24 h after treatment in the control group was lower than that in the observation group(P<0.01 and P<0.05).There was no significant difference in oxygen saturation(SaO_(2)),oxygenation index(PaO_(2)/FiO_(2))and blood lactate(Lac)between the two groups before treatment(P>0.05);SaO_(2),PaO_(2)/FiO_(2)at 6,12 and 24 h after treatment in the two groups were higher than those before treatment(P<0.05),and Lac was lower than that in its group before treatment(P<0.05);SaO_(2)and PaO_(2)/FiO_(2)at 6,12 and 24 h after treatment in the control group were lower than those in the observation group(P<0.05 to P<0.01),while Lac was higher than that in the observation group(P<0.05 to P<0.01).The incidence of complications in the control group was 17.14%(6/35),while that in the observation group was 25.71%(9/35),and the difference of which was not statistically significant(P>0.05).The survival rate within 28 days in the

关 键 词：脓毒性休克 特利加压素 血流动力学 去甲肾上腺素 氧合指数 

分 类 号：R631[医药卫生—外科学]